recent studies form animal models have rekindled our interest in the role of the hypothalamic-pituitary-adrenal (HPA) axis and other neuroendocrine factors in rheumatoid arthritis and other autoimmune diseases. During the past year, we have continued our evaluation of the HPA axis in rheumatoid arthritis and have initiated studies addressing the question of familial aggregation. The data, although still preliminary, are consisted with the hypothesis that some rheumatoid arthritis patients have inappropriately blunted HPA axis responses to inflammation.